Prior authorization can help ensure that patients have access to safe, effective, affordable, high-quality care by helping to guard against potential overtreatment or inappropriate treatments that contribute to unnecessary costs and/or potential harm to patients. However, there is agreement that prior authorization can be burdensome to providers, consumers, and health plans alike. In 2018, stakeholders representing providers and payers worked together to develop a Consensus Statement outlining opportunities to improve the prior authorization process with the following aims:
- Promote timely, affordable access to evidence-based care for patients.
- Enhance efficiency in care delivery.
- Reduce administrative costs.
In this Consensus Statement, increasing the adoption of electronic prior authorization was one of the five major opportunities identified for improving the prior authorization process. In January 2020, building on the multi-stakeholder Consensus Statement, America’s Health Insurance Plans (AHIP), along with several member insurance providers, launched the Fast Prior Authorization Technology Highway (Fast PATH) initiative with the goal of understanding the impact of electronic prior authorization on improving the prior authorization process. This novel initiative and evaluation lay the foundation for more research on strategies for further improving electronic prior authorization.